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<table border=0 cellpadding=0 cellspacing=0 width=576 style='border-collapse:
 collapse;width:432pt'>
<!--StartFragment-->
 <col width=64 span=9 style='width:48pt'>
 <tr height=38 style='height:28.5pt'>
  <td colspan=9 height=38 class=xl91 width=576 style='border-right:1.5pt solid red;
  height:28.5pt;width:432pt'>OPERATIE</td>
 </tr>
 <tr height=53 style='height:39.75pt'>
  <td colspan=2 height=53 class=xl95 width=128 style='border-right:1.0pt solid black;
  height:39.75pt;width:96pt'>Start temperatuur:</td>
  <td class=xl66 width=64 style='width:48pt'>&nbsp;</td>
  <td class=xl68 width=64 style='width:48pt'>&nbsp;</td>
  <td colspan=2 class=xl97 width=128 style='border-right:1.0pt dashed black;
  border-left:none;width:96pt'>&nbsp;</td>
  <td class=xl70 width=64 style='width:48pt'>Eind temperatuur:</td>
  <td class=xl65 width=64 style='width:48pt'>&nbsp;</td>
  <td class=xl65 width=64 style='width:48pt'>&nbsp;</td>
 </tr>
 <tr height=21 style='height:15.75pt'>
  <td height=21 class=xl67 width=64 style='height:15.75pt;width:48pt'>Pols:</td>
  <td colspan=2 class=xl79 width=128 style='border-right:1.0pt solid black;
  border-left:none;width:96pt'>&nbsp;</td>
  <td colspan=3 class=xl99 width=192 style='border-right:1.0pt solid black;
  border-left:none;width:144pt'>&nbsp;</td>
  <td class=xl65 width=64 style='width:48pt'>&nbsp;</td>
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  <td height=36 class=xl69 width=64 style='height:27.0pt;width:48pt'>Ademhaling:</td>
  <td colspan=2 class=xl79 width=128 style='border-left:none;width:96pt'>&nbsp;</td>
  <td colspan=3 class=xl81 width=192 style='border-right:1.5pt solid black;
  width:144pt'>&nbsp;</td>
  <td class=xl65 width=64 style='width:48pt'>&nbsp;</td>
  <td colspan=2 class=xl79 width=128 style='border-right:1.0pt solid black;
  border-left:none;width:96pt'>&nbsp;</td>
 </tr>
 <tr height=36 style='height:27.0pt'>
  <td colspan=9 height=36 class=xl85 width=576 style='border-right:1.0pt solid black;
  height:27.0pt;width:432pt'>???</td>
 </tr>
 <tr height=21 style='height:15.75pt'>
  <td colspan=5 height=21 class=xl89 width=320 style='height:15.75pt;
  width:240pt'>Start OK:<span
  style='mso-spacerun:yes'>                                                                        </span></td>
  <td colspan=4 class=xl80 width=256 style='border-right:1.0pt solid black;
  width:192pt'>uur</td>
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 <tr height=21 style='height:15.75pt'>
  <td colspan=5 height=21 class=xl71 width=320 style='height:15.75pt;
  width:240pt'>Einde OK:<span
  style='mso-spacerun:yes'>                                                                       </span></td>
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  width:192pt'>uur</td>
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  <td colspan=5 height=21 class=xl75 width=320 style='height:15.75pt;
  width:240pt'>Totale tijd:<span
  style='mso-spacerun:yes'>                                                                     </span></td>
  <td colspan=4 class=xl77 width=256 style='border-right:1.0pt solid black;
  width:192pt'>uur</td>
 </tr>
<!--EndFragment-->
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